House Passes SGR Repeal Bill; Senate Adjourns without Taking Action on SGR

1280px-Capitol-SenateAfter nearly 14 years of advocacy and 17 temporary “patches,” on March 26, 2015 — by an overwhelming vote of 392-37 — the U.S. House of Representatives passed H.R. 2, the Medicare Access and CHIP Reauthorization Act, which repeals Medicare’s sustainable growth rate (SGR) payment system. The legislation:

  • Repeals the SGR, prevents the 21 percent Medicare pay cut and provides physicians a period of payment stability with positive updates;
  • Consolidates the current Physician Quality Reporting System (PQRS), Electronic Health Record (EHR) and Value-Based Payment Modifier (VM) programs and eliminates the penalties associated with these programs;
  • Includes positive incentives for quality improvement payment programs that allow all physicians the opportunity to earn bonus payments;
  • Enhances the ability of physicians, rather than the government, to develop quality measures and clinical practice improvement activities;
  • Clarifies that quality improvement program requirements do not create new standards of care for purposes of medical malpractice lawsuits;
  • Reverses the CMS decision to eliminate the 10- and 90-day global surgery payments; and
  • Extends the Children’s Health Insurance Program (CHIP) for two years.

Unfortunately, the Senate failed to act on the House-passed SGR deal before it adjourned in the wee hours of the morning for a two-week recess. Senate Majority Leader Mitch McConnell (R-Ky.) had filed a proposed unanimous consent agreement on H.R.2, which would have allowed for quick action on the bill last night. However, it only takes one Senator to object to this procedure, which happened, thereby preventing the bill from coming to the floor for a vote before recess.

Sen. McConnell has pledged that the Senate would take up the legislation “very quickly” immediately upon its return. He said that he and Senate Minority Leader Harry Reid (D-Nev.) will work together to schedule the vote on the bill. McConnell is optimistic that the Senate will have an easy time passing the bill stating that, “There’s every reason to believe [the bill] is going to pass the Senate by a very large majority.”

Earlier this week, President Obama signaled his strong support for this legislation stating, “I’ve got my pen ready to sign a good, bipartisan bill — which would be really exciting.” In addition to these remarks, the White House issued a Statement of Administration Policy (SAP) officially offering the Obama Administration’s support for passage of H.R. 2.

Physicians need not immediately worry, however, that their payments will be slashed by 21 percent. The Centers for Medicare and Medicaid Services (CMS) has announced that it plans to hold claims for services rendered on or after April 1, 2015. Electronic claims can be held for 14 calendar days and paper claims for 29 days.

To continue to build momentum for SGR repeal, neurosurgeons are encouraged to contact their senators urging them to act now and repeal the SGR once and for all. Click here to send an email message to Congress via the AANS/CNS Legislative Action Center. It takes less than 5 minutes to let your voice be heard, so we hope you will act today!

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Congress on the Verge of Historic Medicare Vote

After 14 years and 17 temporary “patches” to prevent steep Medicare cuts, Congress is finally poised to vote on legislation that will permanently repeal Medicare’s sustainable growth rate (SGR) physician payment formula. If Congress fails to act, physicians face a 21 percent pay cut on April 1, 2015. The problems with the SGR payment system are well-documented, and cuts of this magnitude will seriously threaten timely access to care. On March 26, 2015, the U.S. House of Representatives is scheduled to vote on H.R. 2, the Medicare Access and CHIP Reauthorization Act. H.R. 2 includes a number of key provisions that are essential to keep Medicare working for our nation’s seniors. These include:

  • Permanently repeals the SGR system;
  • Provides positive annual payment updates for five years;
  • Consolidates and streamlines the existing Physician Quality Reporting System (PQRS), Electronic Health Record (EHR)/meaningful use, and Value-Based Payment Modifier (VM) penalty programs;
  • Rescinds the Centers for Medicare and Medicaid Services (CMS) deleterious plan to eliminate 10- and 90-day global surgery payments; and
  • Extends insurance for children under the CHIP program.

The time has come to permanently repeal the SGR. To this end, featured below is a Neurosurgery Blog animation entitled, “Stop the Madness #FixSGR Once and For All.”

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Neurosurgeons Applaud Efforts Made to Repeal the SGR

1236756_10201843651315115_1054821300_nThe AANS and CNS applaud the efforts of leaders in the House of Representatives to pass legislation to repeal and replace Medicare’s flawed sustainable growth rate (SGR) payment formula before the 21 percent pay cut goes into effect on April 1, 2015. The “SGR Repeal and Medicare Provider Payment Modernization Act of 2015,” reflects many of neurosurgery’s core principles and takes the following important steps to transform the way Medicare pays physicians:

  • Repeals the SGR and includes a period of stability in Medicare physician payments;
  • Restructures and streamlines physician-led quality improvement that allows the medical specialty societies to determine the most appropriate and clinically relevant quality improvement metrics and strategies for use in future quality initiatives; and
  • Adopts flexible criteria that allow physician participation and engagement in delivery and payment models that are meaningful to their practices and patient populations, including preserving a fee-for-service option and recognizing the value of clinical data registries for improving quality.

Neurosurgeons appreciate the tireless efforts by leaders in Congress to develop legislation that fixes the broken Medicare payment system. Furthermore, we are encouraged that the bill establishes a stable mechanism for reimbursing doctors and will help create a delivery system that promotes high-quality, high-value, and better-coordinated care for our patients.

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